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The end of Ebola? Getting to zero case by case

Some better news at last from Sierra Leone! After a lot of hard work to break the chain of infection, the number of new Ebola cases in ‘the other’ Waterloo suddenly began to drop steeply from 35 every week in mid-January to the current rate of about 7 (as of 18 Feb.). But even one new case per day is too many: controlling an epidemic is like fighting a forest fire, which appears to be out, but smoulders on and bursts into flames somewhere else. The World Health Organization predicted that the ‘tail’ of this epidemic would be the most difficult part to manage, and could take some months to bring to an end. This is proving to be the case, with numbers falling more slowly now: nationally the number of new cases is unchanged over the last 3 – 4 weeks. If the disease is not totally stamped out, other lethal outbreaks will inevitably erupt; so vigorous contact-tracing and illness searching are under way by the authorities.

Although the number of cases in Waterloo is now far fewer, the patients’ contacts invariably live in large compounds with several families, so 40 or more adults and small children may be involved. The Waterloo Partnership charity is continuing to supply quarantined families with essential food, fuel and water during their 21 day period of enforced quarantine: this reduces the risk of contacts ‘absconding’ and potentially spreading the virus.

In addition, our Chairman’s wife Aminata Mansaray is being helped by members of the community to deliver food and hygiene essentials twice a week to 70 vulnerable children and Ebola orphans, whom we have been feeding since November. We are told that when the children see Aminata arrive, they start chanting (in Krio) “sardine don cam, sardine don cam” (the sardines have arrived). “The packages have been praised as the best because of the variety of the contents and the regularity of supplies”.

After suffering six months of fear and unimaginable social disruption, ‘Saloneans’ are at last more optimistic, with some road-blocks lifted to allow goods and people to get to market, and plans being made for the schools to reopen fairly soon. Unfortunately the lifting of Regional quarantine restrictions has brought more infection into Waterloo from a problematic neighbouring district. Some parents will be hesitant about allowing their children to risk returning to school, and Ebola survivors are being stigmatised. So normality will not return quickly and the future is very uncertain indeed for Sierra Leone, its economy reduced, its fragile health service battered, numerous bereaved and traumatised families, and thousands of Ebola orphans abandoned or vulnerable. Children will have disengaged from school, some in menial employment, with girls turning to prostitution in order to survive. Families have lost their breadwinner: there is no social security to fall back on. Many people have suffered multiple bereavements: our partners tell us they are finding it very difficult to adjust.

The Waterloo Partnership has been overwhelmed by the generous response of our local community here in Merseyside to the needs of our namesake township in SL. It has allowed us to feed 30 destitute Ebola orphans in addition to the 40 vulnerable children whom we normally support – not to mention the many hundreds of quarantined families.

As the epidemic gradually comes to an end, we and our friends in the ‘other Waterloo’ are considering together the most effective ways we can assist this traumatised community, whether in education, health care, farming, or livelihood recovery. The late James Jajua, the Community Health Officer at Waterloo’s Health Centre, predicted shortly before he himself died of Ebola, that the epidemic would cause more devastation than the civil war which came to an end 15 years ago: that is sadly proving to be true.